Ultrasonsically vibrated surgical cutting instrument

ABSTRACT

An improved ultrasonically vibrated surgical cutting instrument for cutting soft tissues without stretching the same during the cutting hereof having an ultrasonic frequency generator, a transducer connected to said ultrasonic frequency generator for creating a vibratory motion and having a vibrator in communication with the transducer, and a double blade knife with one of the blades adapted to move in a longitudinal direction along the motion of the vibrator and the other blade fixed to prevent deflection of the cutting blade during the cutting operation and retaining the tissue against the cutting edge such that when the sharp edge of the knife blades touch soft tissues the knife blades will cut the soft tissues without stretching the membrane.

United States Patent Coleman ULTRASONSICALLY VIBRATED SURGICAL CUTTINGINSTRUMENT Donald Jackson Coleman, 223 Maple St., Haworth, NJ. 07641Filed: Sept. 20, 1974 Appl. No.: 507,978

Related US. Application Data Continuation-impart of Ser. No. 386,867,Aug. 9, I973, abandoned.

Inventor:

US. Cl. 30/272 A; 128/305 Int. Cl. B26b 7/00 Field of Search 30/272 A,272 R; 128/305 References Cited UNITED STATES PATENTS 1 June 10, 1975Primary Examiner-Al Lawrence Smith Assistant Examiner-J. T. ZatargaAttorney, Agent, or Firml(irschstein, Kirschstein, Ottinger & Frank [57) ABSTRACT An improved ultrasonically vibrated surgical cuttinginstrument for cutting soft tissues without stretching the same duringthe cutting hereof having an ultrasonic frequency generator, atransducer connected to said ultrasonic frequency generator for creatinga vibratory motion and having a vibrator in communication with thetransducer, and a double blade knife with one of the blades adapted tomove in a longitudinal direction along the motion of the vibrator andthe other blade fixed to prevent deflection of the cutting blade duringthe cutting operation and retaining the tissue against the cutting edgesuch that when the sharp edge of the knife blades touch soft tissues theknife blades will cut the soft tissues without stretching the membrane.

4 Claims, 8 Drawing Figures ULTRASONSICALLY VIBRATED SURGICAL CUTTINGINSTRUMENT CROSS-REFERENCE TO RELATED APPLICATION This application is acontinuation in part application to my copending application Ser. No.386,867 for a Surgical Instrument filed Aug. 9, 1973, now abancloned.

BACKGROUND OF THE INVENTION l. Field of the Search.

This invention relates to an ultrasonically vibrated surgical cuttinginstrument for cutting soft tissues and more particularly to anultrasonically vibrated surgical cutting instrument having two knifeblades.

2. Prior Art.

Heretofore, it has been known that in an effort to cut soft tissues, forexample, in the eye, the weight ofa surgical knife cutting soft tissuestends to stretch the tissues such that after it has been severed thetissue does not return to its normal pre-severed size until asubstantial time has elapsed, or may be permanently torn from adjacenttissues. It has been found that the reason for the stretching was due tothe necessary weight which had to be placed on the soft tissue in orderfor the sharp surgical edge of the knife to engage the tissue to permitthe commencement of the cutting. The weight of the knife coupled withthe pressure applied by the surgeon was sufficient to depress the tissueand thereby stretch the same providing a somewhat deformed tissue afterthe severance had been made. Varying types of extremely sharp blades ofvery thin material have been used but none to the satisfaction of thesurgical profession and particularly those concerned with intro-ocularsurgery in ophthamology.

The ultrasonically vibrated surgical cutting instrument was developed tosolve this problem. The blade vibrates as a result of longitudinalvibrations injected therein from the driving element. Because of therapid oscillations of the blade much less pressure is applied in thecutting operation than with the ordinary knife.

While less pressure was needed to make the incision using theultrasonically vibrated surgical cutting instrument, the prior artdevices are limited to a single bladed knife. A problem developes whenthe single knife blade encounters increased resistance to cutting. Thereis a tendency for very thin blades to deflect or stray from the linealong which the surgeon wishes to cut. Single blades lack the ability tostabilize the tissue being cut as well as the method using a secondadjacent blade. In the case of delicate operations, it is imperativethat the knife blade be prevented from deflecting to prevent damagingtissue adjacent to the incision, and that the tissue be cut smoothlywithout stretching.

OBJECTS OF THE PRESENT INVENTION It is the general object of the presentinvention to avoid and overcome the foregoing and other difficultieswhich will become apparent as the description proceeds by providing anultrasonically vibrated surgical cutting instrument which has two knifeblades, one of which is fixed and the other of which is free to vibrate.

Another object of the present invention is to provide an ultrasonicallyvibrated surgical cutting instrument having two knife blades, in whichthe fixed blade prevents the moveable blade from deflecting from desiredcutting line.

Yet another object of the present invention is to provide anultrasonically vibrated surgical cutting instrument which is of asimplified construction and can be economically produced.

SUMMARY OF THE INVENTION The objects of the present invention have beenachieved by providing a surgical cutting instrument for use in cuttingsoft tissues without stretching the tissues during the cutting operationbeing provided with ultrasonic frequency generator, a transducer incommunica tion with said ultrasonic frequency generator, a vibratinganvil in communication with said transducer and adopted to vibrate alongthe longitudinal axis thereof. and a double blade knife, one of theknife blades being in communication with said vibrating anvil so thatsaid knife blade will move along the longitudinal axis thereof, whilethe other blade remains fixed and prevents said moveable blade fromdeflecting from a desired cutting line.

BRIEF DESCRIPTION OF THE DRAWINGS For a better understanding of thepresent invention reference should be had to the accompanying drawingwherein like numerals of reference indicate similar parts throughout therespective views and wherein:

FIG. 1 is a profile view of the improved ultrasonically vibratedsurgical cutting instrument in accordance with the present invention.

FIG. 2 is a partial sectional view at an enlarged scale along line 22 inFIG. 1.

FIG. 3 is a sectional view at an enlarged scale along line 3-3 in FIG.1.

FIG. 4 is a sectional view of an alternative knife blade construction.

FIG. 5 is a sectional view of the relationship of the two knife bladesat a greatly enlarged scale.

FIG. 6 is a sectional view along line 6-6 of FIG. 2.

FIG. 7 is a sectional view along line 77 of FIG. 2.

FIG. 8 is a partial view, at an enlarged scale, of an alternative knifeblade construction.

DESCRIPTION OF THE PREFERRED EMBODIMENT As shown in FIG. I, theultrasonically vibrated surgical cutting instrument is generallyindicated by the reference numeral 10. The basic concept of anultrasonically vibrated surgical cutting instrument is old in the artand will not be discussed in detail herein. Basically, the frequenciesdeveloped by an ultrasonic generator are connected to vibratory mount bya transducer. A vibrating anvil in communication with the transducertransmits the vibratory motion to the knife blade of the cuttinginstrument. The surgical cutting instrument 10, has two knife blades 11and 12 which will be described hereinafter in further detail.

As shown in FIG. 2, the ultrasonically vibrated surgical cuttinginstrument 10 has a housing within which the abovementioned ultrasonicgenerator, transducer and vibratory anvil are located. Because thepresent invention is adapted to be used on a conventional ultrasonicallyvibrated cutting instrument, the details of the ultrasonic generator,transducer, and vibrating anvil are not shown. Only a portion of thevibrating anvil is shown and is identified with the reference numeral14.

As the open end of housing 13 is a retaining collar 15, the retainingcollar 15 is mounted to the housing 13 so that it is free to rotatethereon. The projection 16 at the end 17 of the retaining collar 15cooperates with a channel 18 in the end of the housing 13 and isretained therein by the retaining projection 19.

The end portion 20 of the ultrasonically vibrated sur gical cuttinginstrument is releasably secured to the housing 13 by means of theretaining collar 15. Threads 21 on the end 22 of the end portion 20cooperate with threads 23 on the retaining collar 15. For reasons whichwill become apparent hereinafter, the end portion 20 will be drawntowards the housing 13 and become secured thereto. When the retainingcollar is rotated in the opposite direction, the end portion is drawnaway from the housing 13 and can be removed from the retaining collar15.

The end portion 20 has a passageway 24 therethrough within which theconnecting bar 25 is free to pass. The connecting bar 25 is releasablysecured at its one end to the vibrating anvil 14. On the other end ofthe connecting bar 25 is mounted one of the knife blades 11. Releasablymounted to the end of the end portion 20 is a second blade 12. Blade 11is the moveable knife blade and blade 12 is the fixed knife blade.

It is imperative that during the cutting operation the two blades do notseparate. In delicate surgical operations, the surgeon must be sure thathe is making the incision along the exact line that he intends to avoiddamaging surrounding tissue.

The two knife blades 11 and 12 are designed to prevent them fromseparating during the actual cutting operation. As shown in FIG. 3, themoveable knife blade 11 has a keyway 26 cut therein. The fixed knifeblade 12 has a projection 27 which cooperates with the keyway 26 to keepthe two knife blades in a close operating relationship. To furtherprevent separation of the knife blades, the moveable knife blade 11 hasa downward extension 28 which extends over the top of the fixed knifeblade 12. This downward extension 28 of knife blade 11 biases knifeblade 11 against knife blade 12 so that the inside surface 29 of theknife blade 11 and the inside surface 30 of the knife blade 12 meet onlyat the tip 31 where the cutting edge 32 is formed. This biasing actionalso has the effect oflimiting the friction effects between the blades.

An alternative construction for the knife blades is shown in FIG. 4. Thedownward extension 33 of the knife blade 11 has an upward projection 34which cooperates with the downward projection 35 on the knife blade 12to further prevent the knife blades 11 and 12 from separating during thecutting action.

In addition to the structure of the knife blades, the passageway 24 andthe connecting bar 25 are also designed to prevent the knife blades fromseparating. As shown in FIG. 6, the clearance 36 between the connectingbar 25 and the walls of the passageway 24 is at a minimum to prevent theseparation. in addition, as shown in FIG. 7, a projection 37 from thewall 38 of the passageway 24 cooperates with a groove 39 in theconnecting bar 25 to limit the excessive movement of the 4 connectingbar 25 and thus preventing separation of the knife blades.

In FIG. 8, an alternative knife blade construction is shown. Either orboth of the knife blades may be serrated, to enhance the cuttingoperation, along the cutting edge.

In view of the need to change knife blades after each operation, tomaintain sterile conditions, the knife blades 11 and 12 are removeablefrom the vibrating anvil 14 and end portion 20 respectively. Tofacilitate removal of the moveable knife blade 11 and connection bar 25,the end portion 20 of the surgical cutting instrument 10 is releasablysecured to the housing 13 by means of the retaining collar 15 ashereinabove described. The end 40 of the connecting bar 25 mayreleasably engage the vibrating anvil 14 by an conventional means suchas a close tolerance press fit or by means of screw threads. As notedhereinabove, the fixed knife blade 12 is releasably secured to the endportion 20 and can be removed therefrom while the end portion is removedfrom the housing.

In summary, 1 have provided a surgical instrument for the cutting ofvery delicate soft tissues using an ultrasonically controlled surgicalcutting blade which will permit the cutting of the soft tissues withoutthe stretching of the tissues per se, having a moveable knife blade anda fixed knife blade which maintains the moveable blade along the desiredcutting line.

While in accordance with the patent statutes a preferred and alternativeembodiment are shown in detail, it should be particularly understoodthat the invention is not limited thereto or thereby.

1 claim:

1. An improved ultrasonically vibrated surgical cutting instrumenthaving an ultrasonic frequency generator, a transducer in communicationwith said ultrasonic frequency generator for converting ultrasonicenergy to vibratory energy and a vibrating anvil in communication withsaid transducer for providing vibrations wherein the improvementcomprises a fixed knife blade, a moveable knife blade in communicationwith said fixed knife blade and said vibrating anvil and means forpreventing said moveable knife blade from separating from said fixedknife blade during the cutting operation so that said fixed knife bladeprevents said moveable knife blade from deflecting during the cuttingoperation.

2. The device in accordance with claim 1 wherein said preventive meanscomprises a keyway in said moveable knife blade, a projection on saidfixed knife blade in communication with said keyway, and a projection onsaid moveable knife blade in communication with said fixed knife bladeto bias said moveable knife blade against said fixed knife blade.

3. The device in accordance with claim 2 wherein said moveable knifeblade has a serrated cutting edge.

4. The device in accordance with claim 3 wherein said fixed knife bladehas a serrated cutting edge.

1. An improved ultrasonically vibrated surgical cutting instrumenthaving an ultrasonic frequency generator, a transducer in communicationwith said ultrasonic frequency generator for converting ultrasonicenergy to vibratory energy and a vibrating anvil in communication withsaid transducer for providing vibrations wherein the improvementcomprises a fixed knife blade, a moveable knife blade in communicationwith said fixed knife blade and said vibrating anvil and means forpreventing said moveable knife blade from separating from said fixedknife blade during the cutting operation so that said fixed knife bladeprevents said moveable knife blade from deflecting during the cuttingoperation.
 2. The device in accordance with claim 1 wherein saidpreventive means comprises a keyway in said moveable knife blade, aprojection on said fixed knife blade in communication with said keyway,and a projection on said moveable knife blade in communication with saidfixed knife blade to bias said moveable knife blade against said fixedknife blade.
 3. The device in accordance with claim 2 wherein saidmoveable knife blade has a serrated cutting edge.
 4. The device inaccordance with claim 3 wherein said fixed knife blade has a serratedcutting edge.